{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T09:58:40Z","timestamp":1777975120014,"version":"3.51.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institute on Drug Abuse and the Food and Drug Administration\u2019s","award":["R21DA059793"],"award-info":[{"award-number":["R21DA059793"]}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R03CA252767"],"award-info":[{"award-number":["R03CA252767"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study sought to identify the predominant factors associated with tobacco and marijuana\/cannabis use among adolescents according to their sexual identity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the 2023 National Youth Tobacco Survey, we examined current use of e-cigarettes, cigarettes, and marijuana\/cannabis vaping among adolescents. We used dominance analyses and logistic regression models to assess the relative importance of factors linked to tobacco and marijuana\/cannabis use. The analyses were stratified by sexual identity (straight, sexual minorities, unsure) and grade levels (middle-school vs. high-school).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study sample includes 6654 middle-school and 8274 high-school students. Three themes emerge from the dominance analysis. First, exposure to e-cigarette or cigarette use at home or in vehicles consistently ranked as the leading factor associated with smoking and vaping across school levels and sexual identity, explaining up to 44% of the predicted variance. Second, the perception of occasional e-cigarette or cigarette use as little to no harm was a top factor, linked to e-cigarette use among sexual minority students and straight high-school students, as well as cigarette use among straight students and sexual minority high-school students. It explained up to 21.6% and 26.5% of the variance in current e-cigarette and cigarette use, respectively. Third, mental stress was a dominant factor associated with tobacco and marijuana\/cannabis use among sexual minority middle-school students, explaining up to 21% of the variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identifies modifiable factors linked to adolescent tobacco and marijuana use. Public health initiatives targeting these factors may reduce smoking and vaping, especially among sexual minority adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Adolescents in the LGBTQ+\u2005community use tobacco and marijuana at higher rates than their straight peers. This study offers insight into the relative importance of a variety of sociodemographic and environmental factors contributing to increased use. The most dominant factors, identified as immediate environmental exposure, e-cigarette risk perceptions, and mental stress should be prioritized when developing targeted interventions to reduce smoking and vaping in this priority population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntaf097","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T19:54:25Z","timestamp":1746042865000},"page":"2097-2108","source":"Crossref","is-referenced-by-count":3,"title":["Exploring Factors Shaping Tobacco and Marijuana Use Among Sexual Minority Adolescents"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-031X","authenticated-orcid":false,"given":"Meng-Yun","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Social Sciences and Health Policy, Wake Forest University School of Medicine , Winston-Salem, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3767-7600","authenticated-orcid":false,"given":"Darcy","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Department of Translational Neuroscience, Wake Forest University School of Medicine , Winston-Salem, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3182-7188","authenticated-orcid":false,"given":"Rachel","family":"Denlinger-Apte","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Health Policy, Wake Forest University School of Medicine , Winston-Salem, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"2025102119521258700_CIT0001","doi-asserted-by":"publisher","first-page":"E45","DOI":"10.5888\/pcd19.210435","article-title":"20-year trends in tobacco sales and self-reported tobacco use in the United States, 2000-2020","volume":"19","author":"Nkosi","year":"2022","journal-title":"Prev Chronic Dis."},{"issue":"18","key":"2025102119521258700_CIT0002","doi-asserted-by":"publisher","first-page":"475","DOI":"10.15585\/mmwr.mm7218a1","article-title":"Tobacco product use among adults\u2014United States, 2021","volume":"72","author":"Cornelius","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"2025102119521258700_CIT0003","doi-asserted-by":"publisher","first-page":"107032","DOI":"10.1016\/j.addbeh.2021.107032","article-title":"Disparities in the frequency of tobacco products use by sexual identity status","volume":"122","author":"Azagba","year":"2021","journal-title":"Addict Behav."},{"issue":"12","key":"2025102119521258700_CIT0004","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.1093\/ntr\/ntab127","article-title":"Nicotine and tobacco product use and dependence symptoms among us adolescents and adults: differences by age, sex, and sexual identity","volume":"23","author":"Evans-Polce","year":"2021","journal-title":"Nicotine Tob Res."},{"key":"2025102119521258700_CIT0005","doi-asserted-by":"publisher","first-page":"106384","DOI":"10.1016\/j.ypmed.2020.106384","article-title":"Tobacco product use and susceptibility to use among sexual minority and heterosexual adolescents","volume":"145","author":"Garcia","year":"2021","journal-title":"Prev Med."},{"key":"2025102119521258700_CIT0006","doi-asserted-by":"publisher","first-page":"106905","DOI":"10.1016\/j.addbeh.2021.106905","article-title":"Role of sex on the relationship between sexual minority status and past 30-day marijuana use among high school students (YRBS, 2015-2019)","volume":"118","author":"Mantey","year":"2021","journal-title":"Addict Behav."},{"issue":"1","key":"2025102119521258700_CIT0007","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1177\/1090198120965509","article-title":"Adolescent gender identity, sexual orientation, and cannabis use: potential mediations by internalizing disorder risk","volume":"48","author":"Buttazzoni","year":"2020","journal-title":"Health Educ Behav."},{"issue":"2","key":"2025102119521258700_CIT0008","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/10826084.2023.2267114","article-title":"What substances are adolescents vaping? 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